ICD 10 DSM 5 for Anxiety Presentation

Total Page:16

File Type:pdf, Size:1020Kb

ICD 10 DSM 5 for Anxiety Presentation DAY 1 DAY ONE Overview of the concepts, clinical presentation and significance of anxiety disorders Introduction to psychological treatments, GAD,PD,SAD,SP Application of the CBT models and Diagnostic exercise on vignettes DAY 2 DAY 2 Biological Treatments OCD and PTSD Cases and video work DAY 3 Somatoform Disorders, Dissociative Disorders and MUS Measurement in Anxiety Disorders Exam practice including CASC Summary ICD 10 & DSM 5 A short summary ICD 10 - A SUMMARY F 40-F48 NEUROTIC,SRESS RELATED AND SOMATOFORM DISORDERS (ICD-10) F 40 Phobias - agoraphobia, social, specific phobias F 41 Other AD - Panic Disorder, Generalized Anxiety Disorder, Mixed Anxiety and Depressive Disorder ❑ F42 Obsessive Compulsive Disorder ❑ F43 Reaction to severe Stress and Adjustment Disorders ❑ F44 Dissociative { Conversion } Disorder ❑ F45 Somatoform Disorder including Somatization Disorder and Hypochondriacal Disorder F48 Other neurotic disorders including Neurasthenia and Depersonalisation – Derealisation Syndrome ICD 10 DISSOCIATIVE (CONVERSION) DISORDERS (F44) Dissociative (conversion) disorders (F44.0) Dissociative amnesia (F44.1) Dissociative fugue (F44.2) Dissociative stupor (F44.3) Trance and possession disorders (F44.4) Dissociative motor disorders (F44.5) Dissociative convulsions (F44.6) Dissociative anaesthesia and sensory loss (F44.7) Mixed dissociative (conversion) disorders (F44.8) Other dissociative (conversion) disorders Ganser's syndrome Multiple personality (F44.9) Dissociative (conversion) disorders, unspecified ICD 10 SOMATOFORM DISORDERS (F45.0) Somatization disorder (F45.2) Hypochondriacal disorder Body dysmorphic disorder Dysmorphophobia (nondelusional) Hypochondriasis Nosophobia (F45.3) Somatoform autonomic dysfunction Cardiac neurosis Gastric neurosis Genitourinary neurosis (F45.4) Persistent somatoform pain disorder Psychalgia DIAGNOSTIC CATEGORIES DSM 5 Diagnostic Category Examples of Specific Disorders Anxiety Disorders Specific Phobia Social Anxiety Disorder (Social Phobia) Panic Disorder Agoraphobia Generalized Anxiety Disorder Separation Anxiety Disorder Selective Mutism Obsessive-Compulsive and Related Obsessive-Compulsive Disorder Disorders Body Dysmorphic Disorder Hoarding Disorder Hair-Pulling Disorder (Trichotillomania) Excoriation (Skin-Picking) Disorder Trauma and Stressor Related Adjustment Disorders Disorders Acute Stress Disorder Posttraumatic Stress Disorder Reactive Attachment Disorder Disinhibited Social Engagement Disorder DIAGNOSTIC CATEGORIES DSM 5 Diagnostic Category Examples of Specific Disorders Dissociative Disorders Dissociative Identity Disorder Dissociative Amnesia Depersonalization/Derealization Disorder Somatic Symptom and Related Somatic Symptom Disorder Disorders Illness Anxiety Disorder Conversion Disorder (Functional Neurological Symptom Disorder) Factitious Disorder MAJOR CHANGES Change Comment Removes obsessive-compulsive Recognizes a spectrum of obsessive- disorder from category of Anxiety compulsive type disorders, including Disorders and places it in new category body dysmorphic disorder; however, of Obsessive-Compulsive and Related anxiety remains the core feature of Disorders OCD Greater emphasis on comorbidity; e.g., Provides more explicit recognition of use of anxiety ratings in diagnosing comorbidity in having clinicians rate depressive and bipolar disorders level of anxiety in mood disorders Removes ASD and PTSD from Anxiety Groups all stress-related psychological Disorders and places them in new disorders under the same umbrella; category of Trauma and Stressor- Adjustment Disorders may now be Related Disorders coded in context of traumatic stressors MAJOR CHANGES Change Comment Elimination of term “somatoform Eliminates a term few people disorders” (now Somatic Symptom and understood (somatoform disorders) Related Disorders) Hypochondriasis dropped as distinct Eliminates the term “hypochondriasis”; disorder , Somatization called somatic people may now be diagnosed with Symptom Disorder Somatic Symptom Disorder if they focus on physical symptoms or with Illness Anxiety Disorder if they are preoccupied with having a serious illness Factitious Disorder moved to Somatic Associated with other somatic symptom Symptom and Related Disorders disorders, but is distinguished by intentional fabrication of symptoms for no apparent gain other than assuming medical patient role.
Recommended publications
  • SOMATIC SYMPTOM, BODILY DISTRESS and RELATED DISORDERS in CHILDREN and ADOLESCENTS 2019 Edition
    IACAPAP Textbook of Child and Adolescent Mental Health Chapter CHILD PSYCHIATRY & PEDIATRICS I.1 SOMATIC SYMPTOM, BODILY DISTRESS AND RELATED DISORDERS IN CHILDREN AND ADOLESCENTS 2019 edition Olivia Fiertag, Sharon Taylor, Amina Tareen & Elena Garralda Olivia Fiertag MBChB, MRCPsych, PGDip CBT Consultant Child and Adolescent Psychiatrist. Honorary Clinical Researcher, HPFT NHS Trust & collaboration with Imperial College London, UK Conflict of interest: none declared Sharon Taylor BSc, MBBS, MRCP, MRCPsych, CASLAT, PGDip Consultant Child and Adolescent Psychiatrist CNWL Foundation NHS Trust & Honorary Senior Clinical Lecturer Imperial College London, UK. Joint Program Director, St Mary’s Child Sick Girl. Psychiatry Training Scheme Christian Krogh, Conflict of interest: none (1880/1881) National declared Gallery of Norway This publication is intended for professionals training or practicing in mental health and not for the general public. The opinions expressed are those of the authors and do not necessarily represent the views of the Editor or IACAPAP. This publication seeks to describe the best treatments and practices based on the scientific evidence available at the time of writing as evaluated by the authors and may change as a result of new research. Readers need to apply this knowledge to patients in accordance with the guidelines and laws of their country of practice. Some medications may not be available in some countries and readers should consult the specific drug information since not all dosages and unwanted effects are mentioned. Organizations, publications and websites are cited or linked to illustrate issues or as a source of further information. This does not mean that authors, the Editor or IACAPAP endorse their content or recommendations, which should be critically assessed by the reader.
    [Show full text]
  • Chapter 05- Mental, Behavioral and Neurodevelopmental Disorders
    Chapter 5 Mental, Behavioral and Neurodevelopmental disorders (F01-F99) Includes: disorders of psychological development Excludes2: symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99) This chapter contains the following blocks: F01-F09 Mental disorders due to known physiological conditions F10-F19 Mental and behavioral disorders due to psychoactive substance use F20-F29 Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders F30-F39 Mood [affective] disorders F40-F48 Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders F50-F59 Behavioral syndromes associated with physiological disturbances and physical factors F60-F69 Disorders of adult personality and behavior F70-F79 Intellectual disabilities F80-F89 Pervasive and specific developmental disorders F90-F98 Behavioral and emotional disorders with onset usually occurring in childhood and adolescence F99 Unspecified mental disorder Mental disorders due to known physiological conditions (F01-F09) Note: This block comprises a range of mental disorders grouped together on the basis of their having in common a demonstrable etiology in cerebral disease, brain injury, or other insult leading to cerebral dysfunction. The dysfunction may be primary, as in diseases, injuries, and insults that affect the brain directly and selectively; or secondary, as in systemic diseases and disorders that attack the brain only as one of the multiple organs or systems of the body that are involved. F01 Vascular dementia
    [Show full text]
  • Somatoform Disorders – September 2017
    CrackCast Show Notes – Somatoform Disorders – September 2017 www.canadiem.org/crackcast Chapter 103 – Somatoform disorders Episode overview 1. List 5 somatic symptom and related disorders 2. List 5 common presentations of conversion disorders 3. List 6 ddx of somatic symptom disorder Wisecracks 1. List 6 organic diseases that may be mistaken for somatoform disorders 2. Describe the treatment goals of somatoform disorders Somatoform disorders as a diagnosis has been eliminated from the DSM-5! The patient with functional neurological symptom disorder, what was termed conversion disorder previously, requires a careful and complete neurological examination. Rather than miss the subtle presentation of a neurological disorder, it may be appropriate to perform imaging and obtain neurological and psychiatric consultation. Do not assume that the patient with neurological deficits has a psychiatric disorder. Success with the SSD patient depends on establishing rapport with the patient and legitimizing their complaints to avoid a dysfunctional physician-patient interaction. • Avoid telling the SSD patient “it is all in your head” or “there is nothing wrong with you.” These patients are very sensitive to the idea that their suffering is being dismissed. • A useful approach is to discuss recent stressors with the patient and suggest to them that at times our bodies can be smarter than we are, telling us with physical symptoms that we need assistance. This approach alone may transform the ED visit from a standoff between physician and patient, to a grateful patient who develops greater insight and is amenable to referral. • Avoid prescribing unnecessary or addictive medications to the SSD patient. • If you suspect a diagnosis of SSD, refer the patient to primary care or psychiatry for further evaluation and treatment.
    [Show full text]
  • Psychopathology and Somatic Complaints: a Cross-Sectional Study with Portuguese Adults
    healthcare Article Psychopathology and Somatic Complaints: A Cross-Sectional Study with Portuguese Adults Joana Proença Becker 1,*, Rui Paixão 1 and Manuel João Quartilho 2 1 Faculty of Psychology and Education Sciences, University of Coimbra, 3000-115 Coimbra, Portugal; [email protected] 2 Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; [email protected] * Correspondence: [email protected] or [email protected]; Tel.: +351-910741887 Abstract: (1) Background: Functional somatic symptoms (FSS) are physical symptoms that cannot be fully explained by medical diagnosis, injuries, and medication intake. More than the presence of unexplained symptoms, this condition is associated with functional disabilities, psychological distress, increased use of health services, and it has been linked to depressive and anxiety disorders. Recognizing the difficulty of diagnosing individuals with FSS and the impact on public health systems, this study aimed to verify the concomitant incidence of psychopathological symptoms and FSS in Portugal. (2) Methods: For this purpose, 93 psychosomatic outpatients (91.4% women with a mean age of 53.9 years old) and 101 subjects from the general population (74.3% women with 37.8 years old) were evaluated. The survey questionnaire included the 15-item Patient Health Questionnaire, the 20-Item Short Form Survey, the Brief Symptom Inventory, the Depression, Anxiety and Stress Scale, and questions on sociodemographic and clinical characteristics. (3) Results: Increases in FSS severity were correlated with higher rates of depression, anxiety, and stress symptoms. The findings also suggest that increased rates of FSS are associated with lower educational level and Citation: Becker, J.P.; Paixão, R.; female gender.
    [Show full text]
  • The ICD-10 Classification of Mental and Behavioural Disorders : Clinical Descriptions and Diagnostic Guidelines
    ICD-10 ThelCD-10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines | World Health Organization I Geneva I 1992 Reprinted 1993, 1994, 1995, 1998, 2000, 2002, 2004 WHO Library Cataloguing in Publication Data The ICD-10 classification of mental and behavioural disorders : clinical descriptions and diagnostic guidelines. 1.Mental disorders — classification 2.Mental disorders — diagnosis ISBN 92 4 154422 8 (NLM Classification: WM 15) © World Health Organization 1992 All rights reserved. Publications of the World Health Organization can be obtained from Marketing and Dissemination, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; email: [email protected]). Requests for permission to reproduce or translate WHO publications — whether for sale or for noncommercial distribution — should be addressed to Publications, at the above address (fax: +41 22 791 4806; email: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.
    [Show full text]
  • Days out of Role and Somatic, Anxious-Depressive, Hypo-Manic, and Psychotic-Like Symptom Dimensions in a Community Sample of Young Adults Jacob J
    Crouse et al. Translational Psychiatry (2021) 11:285 https://doi.org/10.1038/s41398-021-01390-y Translational Psychiatry ARTICLE Open Access Days out of role and somatic, anxious-depressive, hypo-manic, and psychotic-like symptom dimensions in a community sample of young adults Jacob J. Crouse 1, Nicholas Ho 1,JanScott 1,2,3,4, Nicholas G. Martin 5, Baptiste Couvy-Duchesne 5,6,7, Daniel F. Hermens 8,RichardParker 5, Nathan A. Gillespie 9, Sarah E. Medland 5 and Ian B. Hickie 1 Abstract Improving our understanding of the causes of functional impairment in young people is a major global challenge. Here, we investigated the relationships between self-reported days out of role and the total quantity and different patterns of self-reported somatic, anxious-depressive, psychotic-like, and hypomanic symptoms in a community-based cohort of young adults. We examined self-ratings of 23 symptoms ranging across the four dimensions and days out of role in >1900 young adult twins and non-twin siblings participating in the “19Up” wave of the Brisbane Longitudinal Twin Study. Adjusted prevalence ratios (APR) and 95% confidence intervals (95% CI) quantified associations between impairment and different symptom patterns. Three individual symptoms showed significant associations with days out of role, with the largest association for impaired concentration. When impairment was assessed according to each symptom dimension, there was a clear stepwise relationship between the total number of somatic symptoms and the 1234567890():,; 1234567890():,; 1234567890():,; 1234567890():,; likelihood of impairment, while individuals reporting ≥4 anxious-depressive symptoms or five hypomanic symptoms had greater likelihood of reporting days out of role.
    [Show full text]
  • The Worried Well: Their Identification and Management
    The worried well: their identification and management DAVID MILLER, DCPsych(NZ), Principal Clinical Psychologist and Honorary Lecturer in Psychiatry and Genito-Urinary Medicine TIMOTHY M. G. ACTON, DCPsych, Clinical Psychologist BARBARA HEDGE, DCPsych, Clinical Psychologist University College and Middlesex School of Medicine, London here in this unfortunate extreme, if but a pimple that they have symptoms of infection associated with appears or any slight ache is felt, they distract themselves human immunodeficiency virus (HIV), the causative with terrible apprehensions And so strongly are they agent of acquired immune deficiency syndrome (AIDS), for the most part possessed with this notion that any despite remaining infection free as verified by (often honest finds it more difficult to cure practitioner generally repeated) serological testing and clinical assessment [13- the imaginary evil than the real one. 15]. As a patient group, the worried well are distinguish- Freind, 1727 [1] able from those in the general population who experience raised anxiety as a result of media coverage of HIV/ Recent surveys of psychiatric and psychological disturb- AIDS, and who may as a consequence wish to be tested ance among patients attending sexually transmitted dis- for anti-HIV, but who experience long-term reassurance ease (STD) or genito-urinary medicine (GUM) clinics and absence of inappropriate worry as a result of negative have shown rates of 20-45 per cent morbidity [2-6]. clinical and laboratory findings. This latter group may be Examples
    [Show full text]
  • Psychopathology-Madjirova.Pdf
    NADEJDA PETROVA MADJIROVA PSYCHOPATHOLOGY psychophysiological and clinical aspects PLOVDIV 2005 I devote this book to all my patients that shared with me their intimate problems. © Nadejda Petrova Madjirova, 2015 PSYCHOPATHOLOGY: PSYCHOPHYSIOLOGICAL AND CLINICAL ASPECTS Prof. Dr. Nadejda Petrova Madjirova, MD, PhD, DMSs Reviewer: Prof. Rumen Ivandv Stamatov, PhD, DPS Prof. Drozdstoj Stoyanov Stoyanov, PhD, MD Design: Nadejda P. Madjirova, MD, PhD, DMSc. Prepress: Galya Gerasimova Printed by ISBN I. COMMON ASPECTS IN PSYCHOPHYSIOLOGY “A wise man ought to realize that health is his most valuable possession” Hippocrates C O N T E N T S I. Common aspects in psychophysiology. ..................................................1 1. Some aspects on brain structure. ....................................................5 2. Lateralisation of the brain hemispheres. ..........................................7 II. Experimental Psychology. ..................................................................... 11 1. Ivan Petrovich Pavlov. .................................................................... 11 2. John Watson’s experiments with little Albert. .................................15 III. Psychic spheres. ...................................................................................20 1. Perception – disturbances..............................................................21 2. Disturbances of Will .......................................................................40 3. Emotions ........................................................................................49
    [Show full text]
  • 1 Table 1. List of Read Codes Used in the Studies of Anxiety
    Table 1. List of Read codes used in the studies of anxiety. Number of Read code Description studies Eu41.00 [X]Other anxiety disorders 5 Eu41100 [X]Generalized anxiety disorder 5 Eu41z11 [X]Anxiety NOS 5 Eu41000 [X]Panic disorder [episodic paroxysmal anxiety] 4 Eu05400 [X]Organic anxiety disorder 4 Eu41112 [X]Anxiety reaction 4 Eu41111 [X]Anxiety neurosis 4 Eu41z00 [X]Anxiety disorder, unspecified 4 E202.12 Phobic anxiety 4 E200200 Generalised anxiety disorder 4 E200.00 Anxiety states 4 E200000 Anxiety state unspecified 4 E200z00 Anxiety state NOS 4 Eu40.00 [X]Phobic anxiety disorders 3 Eu40z00 [X]Phobic anxiety disorder, unspecified 3 Eu41012 [X]Panic state 3 Eu41011 [X]Panic attack 3 Eu41y00 [X]Other specified anxiety disorders 3 Eu41300 [X]Other mixed anxiety disorders 3 Eu41211 [X]Mild anxiety depression 3 Eu41113 [X]Anxiety state 3 E200500 Recurrent anxiety 3 E200100 Panic disorder 3 E200111 Panic attack 3 E200400 Chronic anxiety 3 1B1V.00 C/O - panic attack 3 1B13.11 Anxiousness - symptom 3 1B13.00 Anxiousness 3 E200300 Anxiety with depression 3 Eu93200 [X]Social anxiety disorder of childhood 2 Eu34114 [X]Persistant anxiety depression 2 Eu40012 [X]Panic disorder with agoraphobia 2 Eu40y00 [X]Other phobic anxiety disorders 2 Eu41200 [X]Mixed anxiety and depressive disorder 2 Eu93y12 [X]Childhood overanxious disorder 2 Eu41y11 [X]Anxiety hysteria 2 E2D0.00 Disturbance of anxiety and fearfulness childhood/adolescent 2 E2D0z00 Disturbance anxiety and fearfulness childhood/adolescent NOS 2 E202100 Agoraphobia with panic attacks 2 E292400
    [Show full text]
  • Antipsychotic Availability (Other Than Pill/Capsule) Notes Paliperidone
    Antipsychotic Availability Notes (other than pill/capsule) Paliperidone long acting injectable Good for hepatically (Invega) (Sustenna) impaired; Extended Release Quetiapine Extended release Sedating (Seroquel) Risperidone Liquid Increases (Risperdal) Dissolvable Prolactin IM Long acting injectable (Consta) Ziprasidone Liquid Monitor EKG (Geodon) IM Supportive Psychotherapy Club House ACT services NAMI Vocational Rehab Nicotine counseling 1 (or more ) delusions Duration: 1 month or longer Criterion A for Schizophrenia has never been met. Functioning is not markedly impaired Behavior is not obviously odd or bizarre Features: Differential Diagnosis Prevalence: Obsessive-compulsive and ◦ lifetime 0.2 % related disorders ◦ Most frequent is persecutory Delirium • Males > females for Jealous major neurocognitive d/o type psychotic disorder due to • Function is generally better another medical condition than in schizophrenia substance-medication- • Familiar relationship with induced psychotic disorder schizophrenia and Schizophrenia & schizotypal Schizophreniform Depressive and bipolar d/o Schizoaffective Disorder Delusion types Erotomanic Grandiose Jealous Persecutory Somatic Mixed Unspecified • Substance Abuse • Dependence • Withdrawal ◦ Alcohol Divided into 2 ◦ Caffeine groups: ◦ Cannabis ◦ Hallucinogens (with separate ◦ Substance use categories for phencyclidine and other disorders hallucinogens) ◦ Substance-induced ◦ Inhalants disorders ◦ Opioids ◦ Sedatives, hypnotics, and anxiolytics ◦ Stimulants (amphetamine-type
    [Show full text]
  • The Hypochondriac Syndromes: from Somatoform Disorders to Hypochondriac Paraphrenia
    The hypochondriac syndromes: from somatoform disorders to hypochondriac paraphrenia Prof. Dr. Gerald Stöber Department of Psychiatry and Psychotherapy University of Würzburg, Germany [email protected] descriptive psychopathology symptom connections („Symptomverbindungen“) core syndrome / cardinal symptoms facultative symptoms clinical entities („Krankheitsgruppierungen“) nosology of psychic diseases differentiated aetiology Basic diagnostic differences between ICD-10/DSM-IV and Leonhard‘s nosology DSM-IV / ICD-10 Leonhard‘s nosology Diagnosis is made by the Diagnosis is made by the evidence of appearance of a specific symptom constellations minimum number of symptoms (specific symptoms form from a given symptom-catalogue characteristic syndromes), which have to exist over a which run a typical course given period of time. (prognosis). Hypochondriac Symptoms - ungrounded concerns to suffer from severe somatic illness: nosophobia, „malade imaginaire“ (provoked by discomforts) => „classical“ hypochondriac (neurosis) - bodily symptoms without adequate medical explanation - somatic sensation / physical misperception - alienation phenomena of the sphere of body feelings („Leibgefühlsstörung“) - somatic / hypochondriac hallucination Differentiation and significance of somatic sensations and body feelings I - homonym: usual, ordinary somatic sensations generalized or related to distinct organ systems pain and specific, well characterized discomforts; neurologic hyper-, hypo, dys- and paraesthesia „painful, burning, stinging, drilling,
    [Show full text]
  • Tacliyeardia, Occasionlal Extr'a-S'ystoles with Palpitation, Ancl Disorders.3 an Intermnittenlt Pulse
    X4°4144 MEDICALThuf BamwuJO SN&I1 THE VICIOUS CIRCLES OF NEURASTHENIA. [JUNE 27, '914 than a skeleton, and a fatal exitits ofteu closes the scene. THE VICIOUS CIRCLES OF NEUIRASTHENIA. Schofield thus describes tlle circle: BY A vicious circle is often kept up in these cases, wbich it is Absolutely essential to break. They begin, it may be, with loss Br Med J: first published as 10.1136/bmj.1.2791.1404 on 27 June 1914. Downloaded from JAMIESON B. HURRY, M.A., M.D., of appetite from some slight cause. -This'. .. leads to dis- READING. ordered thoughts, and the idea of disease is started. This, again, makes the appetite still more capricious; the thoughts NEURASTHENIA is mnore often than any otiler disorder therefore get still worse, and so the body starves the brain complicated by vicious circles. The result is a clhronic and the brain starves the body.6 self-perpetuating condition, distressing to the sufferer, In8omnnia.-Insomnia is anotlher psychogenous symptom harassinig to tile relatives, and baffling to the plhysician. of neurastlhenia wlhichl ofteln greatly impedes recovery; If a disorder is to be followed by speedy recovery, its the associated cerebral liyperaemia prevents the neurons reactions-for examiple, couglh, diarrhoea, pyrexia, etc.- obtaining the rest on wlliclh their recuperation so greatly must relieve thle primary condition. Such disorders may depends. -Sawyer tlhus describes the circle: be described as self-teriiiinating. Any cause whiclh directly prevents a repose duly deep of a - In nieurastilenia, on tlhe otiler lhalnd, tile reactions per- sufficient ntumber of those brain cells which are the organ-s of petuate tile primary conditioll.
    [Show full text]